Having just spent two days in London working with a major pharmaceutical client, I was able to remind their market access team that even when it looks as though you might not have anything to offer to help solve the NHS’s problems, when you think about things differently you can be a massive part of the solution.
Innovation is the key to bringing the NHS back from the brink
I had connected this client to a commissioner who worked in integrated care system and place commissioning. She spent the whole morning with us, did a great presentation, handled a question and answer session and made an extremely valuable contribution to the sessions.
Her opening gambit was very much in line with my own thinking – the NHS is drowning in workload, there’s far too much for people to do and there aren’t enough staff to meet the demand. We need to act now and innovate, handle patients in different ways because, if we don’t, there is no chance we’re going to be able to deliver.
She was then asked what her top priorities were and she said she had two – handling winter pressure and ambulance waiting times.
There were lots of blank stares in the room at this point. It was as though everybody’s heart sank collectively as they realised her top priorities weren’t diabetes, respiratory disease, cardiovascular disease or any of the other big ticket items. Everyone was thinking the same thing: “I’ve got nothing to offer here.”
Prevention is much better than the cure for the NHS
I spent the remainder of the time working with the brand and marketing teams on pharma market access strategy development, looking at how they can work with those NHS agendas, especially winter pressures.
Ambulance waiting times is a bit of a trickier one, although I argued that if you improve the patient outcome, and the patient doesn’t deteriorate and feel unwell, they’re not calling for an ambulance.
We focused on taking a prevention-led approach to the market access strategy to tackle the problems of the NHS, which is currently sickness led and working in silos. As much as we want general practice, community services, the hospital, the mental health trust and the voluntary sector to all work in an integrated manner, the NHS is still led by the patient becoming unwell, contacting the NHS or turning up in the NHS and then responding to that.
Despite this, there is definitely an appetite for the prevention approach. The commissioner told the group: “I really want to be prevention led, I want to be focused on the front end of the pathway. Of course, I want to prevent people from becoming sick in the first place. But more importantly, when they do become sick, I want to slow disease progression. I want the focus to be on turning the tap off, stopping people coming into the NHS and ending up in hospital and our secondary care environment.”
We’ve got the NHS guidance, now we need to act on it
I then spent time with the market access team sharing strategic NHS insight to help them shape their offer on their value added projects, at where they fit, how we can lead them, the messaging around prevention, and how we can help tackle those agendas of winter pressure and ambulance times.
We then talked about how we can turn this invaluable guidance from the commissioner into solid pathways that can be implemented.
But often the problem is having the right connections and understanding where to get started. One of the benefits of working as a consultant on both the NHS side as well as the Pharma, med tech and device side is the connections I have been able to make over time, bringing clients together for mutual benefit.
In this case, my pharma client was wondering how they could get their ideas off the ground. I was able to reach out to one of my more innovative NHS customers and brief them of the pharma client’s ideas. I relayed the commissioner’s guidance and suggested my NHS client turn this project, which focuses on a specific disease area, into a Local Enhanced Service (LES) so it could quickly be implemented.
My NHS client could immediately see the benefits and jumped at the chance. Of course, they need to go through the official channels, independent of the pharma company, and put a LES proposal in to the place commissioner themselves first – but the fact is the seed has been sown and eyes have been opened to different thinking.
One size doesn’t fit all with NHS market access – go in at Place level
Why is this important? Because the commissioner was telling us that if she had five place footprints under the integrated care system and she wanted them all to move in a certain direction, all five would likely do that in a different way. That’s perfectly allowable, as long as they deliver the outcome.
Pharma, MedTech, and Devices companies target Integrated Care Systems (ICS). But the commissioner pointed out that’s a tough ask right now, because they’re barely set up and they’re not mature, they’ve got lots of vacancies and are still recruiting people to be put into place.
So the chances of actually getting a system-wide decision that you can implement right across an ICS in exactly the same way are almost nil. That’s why the commissioner was telling my client to target the place footprint. That’s usually the local authority footprint (if anyone wants to message me, I will provide a document that shows 42 integrated care systems and the 300 places that are aligned with them).
The advice is to work at place level, then work down from there into the primary care networks and get your projects implemented. A pilot is much more likely in a place footprint first before rolling out system-wide across the other place footprints.
Needless to say, the pharma market access team I had been working with were delighted with the result – now having targeted messaging and a tactical approach to their NHS strategy that will enable them to lay their agenda onto the NHS agenda which, focused on winter pressure and ambulance waiting and handover times, they initially struggled to see a way into.
Scott McKenzie helps pharmaceutical, medical technology and device firms increase revenue by getting their products and services in front of the right NHS decision makers. If you want to get your products fully embedded into treatment pathways we can help you. We’ve doubled revenue for our clients and can share these processes with you too.